Individual
MRS. JAQUETTA BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1045 LYNNHAVEN PKWY, VIRGINIA BEACH, VA 23452-6346
(757) 385-4105
Mailing address
1045 LYNNHAVEN PKWY, VIRGINIA BEACH, VA 23452-6346
(757) 385-4105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710102889
VA
101YP2500X
Professional Counselor
Primary
0701006632
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861562472
—
VA
Enumeration date
05/02/2007
Last updated
01/05/2017
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